Torretta L, Perotti C, Pedrazzoli P, Dornini G, Viarengo G, Livraghi A, Noris P, Da Prada G A, Balduini C L, della Cuna G R, Salvaneschi L
Servizio di Immunoematologia e Trasfusione, IRCCS Policlinico San Matteo, Italia.
Vox Sang. 1998;75(3):224-9.
The use of circulating progenitor cell support following high-dose chemotherapy for malignancies decreases but does not entirely abolish platelet transfusion requirement. We investigated the feasibility of supporting the posttransplant thrombocytopenic phase exclusively with autologous platelets collected by apheresis and cryopreserved.
25 patients underwent plateletpheresis during the platelet rebound occurring after high-dose cyclophosphamide. Autologous platelets were cryopreserved in 5% dimethylsulfoxide, thawed and transfused during the aplastic phase after the myeloablative regimen whenever clinically required.
A single plateletpheresis was carried out in all patients, allowing the harvest of a platelet concentrate with a mean value of 7.7 x 10(11) platelets. No significant procedure- or transfusion-related side effects were recorded. Mean platelet recovery after freezing and thawing was 63% and the mean number of platelet reinfused was 4.8 x 10(11); 23 of 25 patients were fully supported with autologous platelets.
Plateletpheresis performed in our selected group of patients was found to be a safe and effective procedure to collect large amounts of autologous platelets; the numbers obtained proved to be sufficient for the transfusion demand of almost all patients.
恶性肿瘤患者大剂量化疗后使用循环祖细胞支持可减少但不能完全消除血小板输注需求。我们研究了仅用单采法收集并冷冻保存的自体血小板来支持移植后血小板减少期的可行性。
25例患者在大剂量环磷酰胺治疗后血小板回升期间接受了血小板单采。自体血小板在5%二甲基亚砜中冷冻保存，在清髓方案后的再生障碍期，根据临床需要解冻并输注。
所有患者均进行了一次血小板单采，采集的血小板浓缩物平均含有7.7×10¹¹个血小板。未记录到明显的与操作或输血相关的副作用。冷冻和解冻后的血小板平均回收率为63%，平均回输的血小板数量为4.8×10¹¹个；25例患者中有23例完全由自体血小板支持。
在我们选定的患者组中进行的血小板单采是一种安全有效的收集大量自体血小板的方法；所获得的血小板数量被证明足以满足几乎所有患者的输血需求。
